Controlling meticillin-susceptible Staphylococcus aureus: not simply meticillin-resistant S. aureus revisited

Despite a large body of work evaluating the ability of meticillin-resistant Staphylococcus aureus (MRSA) screening and decolonization to decrease the risk of MRSA infection and transmission, many uncertainties remain regarding the efficacy of this strategy in hospitals located in endemic areas. With meticillin-susceptible S. aureus (MSSA), the objective is simply to eradicate the organism in order to diminish the risk of infection. MSSA decolonization was recently found to be effective in high-risk clean surgery, where the intervention was cost-effective and cost-saving. The many unanswered issues include the role for rapid screening tests, the optimal decolonization regimen, the indication for decolonization in other situations at risk, the frequency of replacement of S. aureus infections with infections due to other micro-organisms, and the risk of emergence of mupirocin resistance.